What are the indications for aortic valve replacement AVR in aortic stenosis and aortic regurgitation?

We recommend that asymptomatic patients with an aortic valve area of less than 0.8 cm2 undergo valve replacement. Similarly, any evidence of impaired LV function (e.g., decreased ejection fraction, LV dilation, or significantly elevated LV diastolic pressure at rest or with exercise) is an indication for AVR.

How do valvular heart issues impact on pregnancy?

Hemodynamics in Pregnancy Significant hemodynamic changes occur during pregnancy, which can lead to decompensation in the setting of severe valvular disease. Cardiac output increases by 30-50% due to increased stroke volume and, to a lesser extent, increased heart rate later in pregnancy.

Does mitral valve affect pregnancy?

Adverse fetal outcomes associated with mitral stenosis include preterm delivery, intrauterine growth retardation, low birth weight and fetal or neonatal death. The most likely explanation for these adverse events is uteroplacental insufficiency secondary to left heart obstruction.

Which of the cardiac condition is normal during pregnancy?

Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) are well tolerated in pregnancy unless they are large or complicated by pulmonary vascular disease. Pre-pregnancy evaluation of the presence of a (residual) defect, cardiac dimensions and estimation of pulmonary pressures are recommended.

What is criteria for aortic valve replacement?

Inclusion Criteria

  • Patient has severe aortic valve stenosis per echo: mean gradient >40 mmHg or jet velocity greater than 4.0m/s and an aortic valve area of <0.8 cm2 or indexed EOA <0.5 cm2/m2.
  • NYHA >2.
  • Probability of death or serious, irreversible morbidity >50%

When is valve replacement recommended?

The aortic valve may need to be replaced for 2 reasons: the valve has become narrowed (aortic stenosis) – the opening of the valve becomes smaller, obstructing the flow of blood out of the heart. the valve is leaky (aortic regurgitation) – the valve allows blood to flow back through into the heart.

Why mitral stenosis is common in pregnancy?

In pregnancy. Mitral stenosis is occasionally encountered in pregnant women, especially in developing countries, where rheumatic fever is endemic. During pregnancy, there is a progressive increase in blood volume, heart rate and cardiac output which reach their peak levels at 28-32 weeks of gestation.

Which valvular disease causes death during Labour?

Mitral stenosis (MS), the most common manifestation of rheumatic heart disease, remains the most common acquired valvular lesion in pregnant women and the most common cause of maternal death from cardiac causes worldwide.

Is it safe to get pregnant with mitral valve prolapse?

Women with MVP in the absence of other cardiovascular disorders may tolerate pregnancy well and do not develop remarkable cardiac complications. Although rare, more serious complications of MVP, such as arrhythmia, infective endocarditis and cerebral ischemic events, have been reported during pregnancy.

What are the signs and symptoms of heart disease in pregnancy?

Heart disease during pregnancy can cause the following signs and symptoms:

  • Chest pain.
  • Lightheadedness/Fainting.
  • Fatigue.
  • Rapid heart rate (tachycardia) of more than 100 beats per minute.
  • Increased need to urinate at night.
  • Persistent cough.
  • Severe shortness of breath.
  • Swelling of feet, hands, ankles, and arms.

What causes cardiac disease in pregnancy?

From the conception of pregnancy, mothers should receive counsel regarding risk factors attributed to cardiac disease of pregnancy. These risk factors include drug use, alcohol abuse, hypertension, diabetes mellitus, pre-existing heart disease, myocarditis, and familial heart disease of pregnancy.

Who is not a candidate for aortic valve replacement?

For TAVR to be recommended, the evaluation must confirm the following: You have aortic stenosis that is severe in nature and is causing symptoms. You are not a candidate for surgical aortic valve replacement or you’re at high risk for surgery and likely would benefit from TAVR therapy.